The great Greek physician and teacher Hippocrates (460 BC-370 BC) described several kinds of cancer, referring to them with the Greek word "carcinos", meaning crab or crayfish. This name comes from the appearance of the cut surface of a solid malignant tumor, with the "veins stretched out on all sides as the animal the crab has its feet, whence it derives its name."

For the past couple of years, my life has been pretty easy. I spent last summer putting in a vegetable garden, and making improvements in the landscaping around my home. In September I went back to work after a somewhat abbreviated bout of retirement, but just part time covering other radiation oncologists’ practices. My two Scottish Deerhound sisters, Queen and Quicksilver were then approaching 7 years old, and were long past the destructive behavior so characteristic of the giant breeds in their youth. My little mixed breed rescue Yoda had never been a problem.

On December 19, 2015 I upended my quiet comfortable life by getting a new puppy, a ten week old borzoi named Pibb. Two weeks later, I compounded the chaos by acquiring a “brother” for him to play with, an eighteen week old Scottish deerhound puppy named Cole. Despite a few misgivings and knowing full well what I was getting myself into, I went ahead with what I knew deep in my heart was a preemptive strike. Queen had been limping off and on, and despite my denial I knew that the proverbial “other shoe” had dropped. Her chronic lameness worsened suddenly a few weeks ago and like her dam before her, she was diagnosed with osteosarcoma, a bone cancer common in her breed.

As a radiation oncologist for adults with cancer, my day to day ethical challenges are few. I do my very best to be sure that my patients understand their diseases, and the side effects, risks and benefits of treatment. As a devastated dog owner, the decision making process is not so simple. The tell tale X-rays resulted in a consultation with a board certified veterinary oncologist, where my husband and I sat and listened to our options. Amputation and chemotherapy, the standard of care, would give Queen a median survival of 9 months. Untreated the disease progresses rapidly, often times resulting in a pathologic fracture. Pain control is also a problem, and pain can often be ameliorated by radiation therapy–my own specialty. Except in the rarest of cases, the disease is incurable because metastases are present, whether they can be detected or not. All treatment is palliative.

As we sat with the veterinary oncologist two weeks ago, contemplating our options, I remembered my friend and vet oncologist Dr. Greg Ogilvie saying, “The dog doesn’t look in the mirror and say, ‘Oh, I only have three legs.’ The dog only knows that the pain is gone.” And we were told that dogs tolerate chemotherapy exceptionally well, much better than human beings. So we sat and nodded and thought that perhaps our initial instinct, which was to provide comfort care only, might be wrong. Who knows better than a cancer doctor how important it is to provide and maintain hope? And so we wavered.

In her incomparable essay “Oyez a Beaumont”, Vicki Hearne describes what it was like to lose her Airedale Gunner when he fractured his pelvis from prostate cancer. As a dog trainer, her advice to clients has never wavered: ”Another dog, same breed, as soon as possible.” And then she admits to us, that it was ten years between the death of Gunner and the purchase of a new Airedale pup. She says, with feigned indifference as our hearts break, “That was as soon as I could get to it,what with one thing or another.” I got to it a little sooner.

Deerhounds are homebodies, and our Queen particularly so. Carsick since puppyhood, trips are stressful for her, and the risk of fracture even getting such a large dog in and out of the car is significant. Outside the veterinary specialty hospital, in the cold light of day, we lifted her into the car and she fell immediately into a sound sleep because she knew she was going home-home to her sister, her humans, and even those pesky puppies. We knew then that home is where she will be for what remains of her life. We love her and this, more than anything, is what we owe her.

About

In 2012, I realized that my thirty plus years of practice as a radiation oncologist had provided me with an abundance of stories–happy, sad, compelling and inspiring–and that these stories needed to be told. Along the way, stories from my “other life” as a mother of three, a daughter, an animal lover, and an occasional world traveler crept in. I hope you enjoy my stories as much as I enjoy telling them.